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A Snapshot of Sanitation in South Asia
with a focus on inequities A regional perspective based on data from the
WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation
Prepared by the WHO/UNICEF Joint Monitoring Programme
for Water Supply and Sanitation
for
Fourth South Asia Conference on Sanitation (SACOSAN-4)
4-7 April 2011
Colombo, Sri Lanka
© U
NIC
EF
/NY
HQ
2006
-0342/P
irozzi;
India, 638
Pakistan, 48
Nepal, 15
Bangladesh, 11
Afghanistan, 4.3
Sri Lanka, 0.20%
20%
40%
60%
80%
100 %
5
10
0%
20%
40%
60%
80%
100 %
0%
20%
40%
60%
80%
100 %
Sanitation coverage trends South Asia Sanitation coverage trends, South Asia,1990 – 2008
Improved
facilities
Shared
facilities
Open
Defecation
Unimproved
facilities
1990 2008 1990 2008 1990 2008
22
45
5
67
10
35
6
10
18
53
6
23
19
10
14
58
81
26
11
57
6
3
10
5
Urban Rural Total
India
638 million
716 million people in South Asia
practiced open defecation in 2008
Sanitation coverage, 2008
Urban
National
Rural
There is significant inequity in the use of improved
sanitation facilities between urban and rural areas
There were more people without access to
improved sanitation in 2008 than in 1990 Since 1990, the population without an improved sanitation facility
increased by 135 million
Urban/rural disparities in the population without improved
sanitation, South Asia,1990 and 2008 (millions)
(millions)
Countries in South Asia with ≥ 100,000 people
practicing open defecation, 2008
0% - 30%
31% - 50%
51% - 75%
76% - 100%
No or insufficient data
134
762
203
828
0
100
200
300
400
500
600
700
800
900
Urban Rural
Po
pu
lati
on
(m
illio
ns)
1990
2008
Covera
ge (
%)
Sanitation trends by wealth quintiles
India provided more than 166 million people
with access to sanitation since 1995. That is
more people than the population of Japan and
the Canada combined!
Progress was, however, highly inequitable:
the poorest households hardly benefitted
Trend analysis of sanitation practices by wealth quintiles, 1995 – 2008; Special tabulation based on India: NFHS 1996, 2001 and 2006; Nepal: DHS 1996, 2001 and 2006; Bangladesh: DHS 1994,
DHS 1997, 2000, 2004 and 2007. Source: Preliminary analysis by WHO/UNICEF JMP; Asset index used for wealth quintile classification has not been adjusted for sanitation
Poorest 2nd 3rd 4th Richest
0
20
40
60
80
100
0
20
40
60
80
100
India
Nepal
1995 2008 1995 2008 1995 2008 1995 2008 1995 2008
0
20
40
60
80
100
Covera
ge (
%)
Covera
ge (
%)
Covera
ge (
%)
1995 2008 1995 2008 1995 2008 1995 2008 1995 2008
1995 2008 1995 2008 1995 2008 1995 2008 1995 2008
Poorest 2nd 3rd 4th Richest
Poorest 2nd 3rd 4th Richest
Household sample surveys like the India National Family Health Survey (NFHS), the Demographic and Health Survey
(DHS) and the Multiple Indicator Cluster Survey (MICS) allow for the classification of households by wealth based on an
index comprised of different household assets. Such classification allows the comparison of sanitation practices between
the poorest and richest 20% of the households. For the three countries below there are at least three such household
surveys available, based on which trends for different sanitation practices have been assessed over the period 1995 –
2008.
Since 1995, 5.4 million people in Nepal gained
access to an improved sanitation facility. Due
to population growth, the number of people
without improved types of sanitation facilities
increased from 18.1 million to 19.8 million.
Little or no progress was recorded among the
poorest 40% of the population.
Bangladesh
Open defecation rates across all quintiles
decreased dramatically. Use of improved
types of sanitation facilities more than tripled
among the poorest and more than doubled
among those in the second quintile.
0
1
2
3
4
5
6
Poorest 2nd 3rd 4th Richest
(mill
ions)
1995 2008
0
5
10
15
20
Poorest 2nd 3rd 4th Richest
(mill
ions)
1995 2008
0
50
100
150
200
Poorest 2nd 3rd 4th Richest
(mill
ions)
1995 2008
Beyond averages and percentages is there equitable progress?
Among the poorest the number of people
practicing open defecation increased
More than 166 million people gained access to
improved sanitation, but gains were highly inequitable
India
Proportion of the population gaining access to an improved type of sanitation facility
1995 – 2008 by wealth quintiles; special tabulation based on DHS 1996, 2001 and 2006
Population practicing open defecation, 1995 and 2008 by wealth quintiles; special
tabulation based on DHS 1996, 2001 and 2006
Nepal
Proportion of the population gaining access to an improved type of sanitation facility
1995 – 2008 by wealth quintiles; special tabulation based on NFHS 1996, 2001 and 2006
Population practicing open defecation, 1995 and 2008 by wealth quintiles; special
tabulation based on NFHS 1996, 2001 and 2006
The number of people practicing open defecation
only decreased among the 60% richest
The richest 40% counted for almost 70% of the
population gaining access to improved sanitation
Proportion of the population gaining access to an improved type of sanitation facility 1995 –
2008 by wealth quintiles; special tabulation based on DHS 1994, 1997, 2000, 2004 and 2007
Population practicing open defecation, 1995 and 2008 by wealth quintiles; special
tabulation based on DHS 1994, 1997, 2000, 2004 and 2007
Bangladesh
The number of people practicing open defecation
decreased significantly across all quintiles
Progress more equitable across all wealth quintiles
in Bangladesh
16%
23%
23%
22%
16% Poorest
2nd
3rd
4th
Richest
8%
20%
37%
32%
Poorest
2nd
3rd
4th
Richest
9%
21%
46%
21%
Poorest
2nd
3rd
4th
Richest
3%
3%
Source: Preliminary analysis by WHO/UNICEF JMP; Asset index used for wealth quintile classification has not been adjusted for sanitation
India
Nepal
Bangladesh
Sanitation coverage trends by country
Ethiopia
Sudan
Open defecation rates across South Asia have declined by more than a third,
several countries recorded much larger declines
6
9
2
6
0
20
40
60
80
100
5
6
9 9 7
9
0 2
3
4
4 1
Proportion of the population practicing open defecation, 1990 and 2008 (unless otherwise noted)
* Afghanistan relates to 1995 instead of 1990, Bhutan relates to 2000 instead of 1990
Proportion of the population using improved sanitation facilities, rural and urban, 2008
Trends in sanitation coverage 1990 - 2008
Some countries show much larger inequities between urban and rural areas than others
Trend analysis of sanitation practices by country, 1990 – 2008, except for Afghanistan: 1995-2000 and Bhutan: 2000-2008
There are no data available for the proportion of the population that shares a sanitation facility of an otherwise improved type for Afghanistan, Bhutan and Maldives
3
5
80 74
51
36 33
22
14 9
52 54
27
16 7 2 1
9
0
20
40
60
80
100
Nepal India Pakistan Afghanistan* Bangladesh Maldives Sri Lanka Bhutan*
1990 2008
1990 2008 1990 2008 1990 2008 1995 2008 2000 2008 1990 2008 1990 2000 1990 2008
India Nepal Pakistan Afghanistan Bhutan Bangladesh Maldives Sri Lanka
Covera
ge (
%)
Covera
ge (
%)
Covera
ge (
%)
37
98
36
22
33
62
14
45
39
74
13
18
18
15
51
29
54
31
69
10
28
53
65
91
70 18
25
35
47
16
27
29 26
23
11
31 4
11
80
52
27 21
52
30 29
54
92 96
51 54 56
60
72
87 88
100
0
20
40
60
80
100
Nepal India Bangladesh Afghanistan Pakistan Bhutan Sri Lanka Maldives
Rural Urban
Sanitation coverage data
Rest of
South Asia
Nigeria
Ethiopia
Sudan
•1995-2008 estimates are given for Afghanistan.
• Data not available to the WHO/UNICEF JMP are marked with a “ – “
Sanitation coverage: Country estimates by type of sanitation practices, 1990, 2000, 2008
Country, area or
territory Year
Population
Sanitation Coverage (%)
Population
gaining access
1990 – 2008
(x1,000)
Urban Rural Total
Total
(x1,000)
Urban
(%) Imp
rov
ed
Sh
are
d
Un
imp
rov
ed
Op
en
defe
cati
on
Imp
rov
ed
Sh
are
d
Un
imp
rov
ed
Op
en
defe
cati
on
Imp
rov
ed
Sh
are
d
Un
imp
rov
ed
Op
en
defe
cati
on
Afghanistan
1990 12,580 18 - - - - - - - - - - - -
4,917* 2000 20,536 21 46 - 43 11 28 - 40 32 32 - 40 28
2008 27,208 24 60 - 38 2 30 - 50 20 37 - 47 16
Bangladesh
1990 115,632 20 59 27 7 7 34 16 10 40 39 18 10 33
39,704 2000 140,767 24 57 26 12 5 43 20 13 24 46 21 13 20
2008 160,000 27 56 26 15 3 52 24 16 8 53 25 15 7
Bhutan
1990 549 16 - - - - - - - - - - - -
- 2000 561 25 87 - 9 4 54 - 35 11 62 - 29 9
2008 687 35 87 - 9 4 54 - 35 11 65 - 26 9
India
1990 862,162 26 49 19 4 28 7 1 2 90 18 6 2 74
211,049 2000 1,042,590 28 52 20 6 22 14 3 4 79 25 8 4 63
2008 1,181,412 29 54 21 7 18 21 4 6 69 31 9 6 54
Maldives
1990 216 26 100 - 0 0 58 - 12 30 69 - 9 22
150 2000 272 28 100 - 0 0 74 - 7 19 81 - 5 14
2008 305 38 100 - 0 0 96 - 0 4 98 - 0 2
Nepal
1990 19,105 9 41 24 5 30 8 2 5 85 11 4 5 80
6,829 2000 24,432 13 47 27 4 22 19 5 5 71 23 8 5 64
2008 28,810 17 51 30 4 15 27 7 6 60 31 11 6 52
Pakistan
1990 115,776 31 73 6 14 7 8 1 20 71 28 3 18 51
47,211 2000 148,132 33 72 6 16 6 20 3 23 54 37 4 21 38
2008 176,952 36 72 6 17 5 29 5 26 40 45 5 23 27
Sri Lanka
1990 17,290 17 85 7 4 4 67 2 15 16 70 3 13 14
6,152 2000 18,767 16 87 7 3 3 81 3 8 8 82 4 7 7
2008 20,061 15 88 7 3 2 92 3 4 1 91 4 4 1
South Asia
1990 1,143,309 25 53 18 6 23 11 3 5 81 22 6 5 67
317,872 2000 1,396,057 27 55 19 8 18 19 5 7 69 29 9 7 55
2008 1,595,454 29 57 19 10 14 26 6 10 58 35 10 10 45
Disclaimer:
1. The definitions of improved and unimproved sanitation facilities used throughout this document are those used for monitoring progress towards the MDG sanitation
target. These are standard definitions used by the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP) and may differ from definitions of
access to sanitation used nationally.
2. The sanitation trend analysis by wealth quintiles presented in this document has been done only for those countries in South Asia for which at least three nationally
representative household sample surveys are available which allow for a classification of households by wealth quintile based on an asset index.
3. For the sanitation trend analysis by wealth quintiles improved sanitation includes all the households which use an improved type of sanitation facility. This includes the
use of facilities that are shared between two or more households. As such this presents a slight over estimation of access to improved sanitation, from which shared
sanitation facilities of an improved type are usually excluded.
For further information and details on definitions please visit the WHO/UNICEF JMP website at: www.wssinfo.org
